Social media use and prospective suicidal thoughts and behaviors among adolescents at high risk for suicide

Social media use in adolescents with and without mental health conditions

Concerns about the relationship between social media use and adolescent mental health are growing, yet few studies focus on adolescents with clinical-level mental health symptoms. This limits our understanding of how social media use varies across mental health profiles. In this Registered Report, we analyse nationally representative UK data (N = 3,340, aged 11-19 years) including diagnostic assessments by clinical raters alongside quantitative and qualitative social media measures. As hypothesized, adolescents with mental health conditions reported spending more time on social media and were less happy about the number of online friends than adolescents without conditions. We also found hypothesized differences in social media use by condition type: adolescents with internalizing conditions reported spending more time on social media, engaging in more social comparison and experiencing greater impact of feedback on mood, alongside lower happiness about the number of online friends and lower honest self-disclosure. In contrast, those with externalizing conditions only reported higher time spent. These findings emphasize the need to consider diverse adolescent mental health profiles in policy and clinical practice.

Problematic social media use and relationship to mental health characteristics in youth from the Texas Youth Depression and Suicide Research Network (TX-YDSRN)

BACKGROUND

The relationship between social media and mental health, particularly in youth, is an area of concern for researchers, clinicians, and parents. Rising rates of screen time have coincided with an increase in youth mental health issues, emphasizing the need to investigate the prevalence and clinical correlates of problematic social media use.

METHODS

Our sample is a 489-participant sub-sample of the Texas Youth Depression and Suicide Research Network (TX-YDSRN) Registry, which is comprised of Texas youth receiving care for depression, suicidal ideation and/or suicidal behaviors. Prevalence of problematic social media use was identified, and indicators of mental and physical health were compared in those with or without problematic use.

RESULTS

In our sample, 40.3 % of participants reported problematic social media use, and those with problematic use were more likely to report higher amounts of screen time. Relative to non-problematic users, problematic users endorsed more and higher depressive symptoms, anxiety, and suicidal thoughts, as well as poorer wellness factors. Participants with high duration and problematic use had poorer outcomes than those with low duration and non-problematic use.

LIMITATIONS

The cross-sectional design does not allow for control comparisons and is limited by use of a single time point. Data are mainly derived from self-report measures, and generalizability of the findings may be impacted by overrepresentation of white females in the sample.

CONCLUSIONS

As use increases, these data contribute to the empirical literature on the complex relationship between social media and mental wellbeing, suggesting problematic use is associated with poor mental health outcomes.

The functional heterogeneity of non-suicidal self-injury: insights from latent profile analysis

BACKGROUND

The functional aspects of non-suicidal self-injury (NSSI) among adolescents represent a complex phenomenon requiring deeper understanding. While research has identified various NSSI functions, including emotional regulation, attention-seeking, and social avoidance, the field lacks comprehensive analysis of how these functions cluster into distinct profiles. Understanding these functional profiles is crucial for developing targeted interventions.

METHOD

A cross-sectional study of 1,783 adolescents (1,464 girls, 318 boys) aged 12-18 years was conducted across 14 psychiatric or general hospitals in nine Chinese provinces. Participants completed the Functional Assessment of Self-Mutilation (FASM), which assesses 22 distinct NSSI functions across three primary dimensions: emotional regulation, attention-seeking, and social avoidance. Additional measures included the Patient Health Questionnaire (PHQ-9) for depression and Generalized Anxiety Disorder Scale (GAD-7) for anxiety symptoms. Latent profile analysis was employed to identify distinct patterns in NSSI functions, with model selection based on fit indices including AIC, BIC, entropy, and LMRT.

RESULTS

Latent profile analysis revealed four distinct functional profiles: low attention-seeking-high social avoidance (LA-HS, 19.7%), high attention-seeking-high social avoidance (HA-HS, 9.5%), low attention-seeking and social avoidance (LA-LS, 57.8%), and high attention-seeking-low social avoidance (HA-LS, 13.0%). The HA-HS profile demonstrated the most severe clinical presentation, showing significantly elevated scores in NSSI frequency (M = 26.160, SD = 9.771), anxiety (GAD-7: M = 16.265, SD = 4.951), and depression (PHQ-9: M = 20.612, SD = 6.003). The LA-HS profile showed the second-highest severity (NSSI: M = 25.800, SD = 10.058; GAD-7: M = 14.775, SD = 5.376; PHQ-9: M = 19.966, SD = 5.938). Both profiles also demonstrated significantly higher rates of suicidal ideation (HA-HS: 77.6%; LA-HS: 79.2%) compared to other profiles.

CONCLUSIONS

Our findings reveal distinct patterns in how adolescents utilize NSSI functionally, particularly regarding attention-seeking and social avoidance dimensions. These functional profiles show meaningful associations with psychological outcomes, suggesting that understanding NSSI functions, rather than just behaviors, may be crucial for assessment and intervention. The identification of these distinct functional profiles among Chinese adolescents highlights the importance of function-specific approaches in clinical assessment and treatment planning.

The Role of Neural Sensitivity to Social Evaluation in Understanding "for Whom" Social Media Use May Impact Emotional Health During Adolescence

There is much interest in the role of social media (SM) in the current mental health crisis among teens. In this review, we focus on the question of "for whom" SM experiences have the strongest impact on emotional health, considering neural sensitivity to social evaluation as a potential vulnerability factor that makes youth more susceptible to the effects of SM. We first present behavioral evidence showing that sensitivity to social evaluation moderates the link between SM use and emotional health in youth. Next, we show that the brain's affective salience network responds to simulated online social threats in ways that predict emotional health. Finally, we show evidence that neural sensitivity to online social evaluation moderates the effects of peer social experiences on emotional health, with implications for social media experiences. We end with recommendations for fully testing the model.

Positive and negative social media experiences and proximal risk for suicidal ideation in adolescents

BACKGROUND

Social media (SM) has received considerable attention as a potential risk factor for adolescent suicide. Few empirical studies, however, have examined adolescents' daily negative and positive experiences on SM and its proximal impacts on suicidal ideation (SI), particularly using intensive monitoring designs.

METHOD

Adolescents (N = 60; 14-17 years; 49% girls; 62% LGBTQ+) recruited using SM across the United States and participated in an 8-week intensive monitoring protocol. Ecological momentary assessment (three brief surveys per day) asked about negative and positive SM experiences and SI (passive and active). Multilevel modelling was used to evaluate the within-person relationships between daily SM experiences (e.g. individual fluctuations compared to a person's average) and SI, controlling for average levels of SM experiences, SM use screen time, and lifetime SI.

RESULTS

Significant within-person effects of negative and positive SM experiences were associated with days when adolescents had SI. Specifically, on days when teens endorsed more frequent negative SM experiences than usual, they were more likely to report SI. However, more positive SM experiences than usual were associated with a lower likelihood of having SI. There were no significant effects of SM use ('screen time') on SI or on the reverse associations of SI on next-day SM experiences.

CONCLUSIONS

Results indicate that SM experiences may be dynamic and modifiable risk and protective factors for SI in adolescents, whereas there is no effect of SM screen time on SI. Our results highlight that targeting negative SM experiences and augmenting the positive experiences on SM may be critical targets to improve teens' mental health and prevent suicide, rather than focusing on limiting SM screen time.

Weekly links among irritability and suicidal thoughts and behaviors in high-risk youth

BACKGROUND

Previous studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait-like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within-person processes of elevated risk in clinically meaningful time periods.

METHODS

The present study used clinical data from 689 adolescents aged 12-19 years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self-report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care.

RESULTS

Overall, two-thirds of variance in weekly irritable mood was accounted for by between-person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity.

CONCLUSIONS

Our results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression.

Exploring Korean adolescent stress on social media: a semantic network analysis

Background

Considering that adolescents spend considerable time on the Internet and social media and experience high levels of stress, it is difficult to find a study that investigates adolescent stress through a big data-based network analysis of social media. Hence, this study was designed to provide basic data to establish desirable stress coping strategies for adolescents based on a big data-based network analysis of social media for Korean adolescent stress. The purpose of this study was to (1) identify social media words that express stress in adolescents and (2) investigate the associations between those words and their types.

Methods

To analyse adolescent stress, we used social media data collected from online news and blog websites and performed semantic network analysis to understand the relationships among keywords extracted in the collected data.

Results

The top five words used by Korean adolescents were counselling, school, suicide, depression, and activity in online news, and diet, exercise, eat, health, and obesity in blogs. As the top keywords of the blog are mainly related to diet and obesity, it reflects adolescents' high degree of interest in their bodies; the body is also a primary source of adolescent stress. In addition, blogs contained more content about the causes and symptoms of stress than online news, which focused more on stress resolution and coping. This highlights the trend that social blogging is a new channel for sharing personal information.

Conclusions

The results of this study are valuable as they were derived through a social big data analysis of data obtained from online news and blogs, providing a wide range of implications related to adolescent stress. Hence this study can contribute basic data for the stress management of adolescents and their mental health management in the future.

A Pilot Case-Control Study of the Social Media Activity Following Cluster and Non-Cluster Suicides in Australia

Social media may play a role in the "contagion" mechanism thought to underpin suicide clusters. Our pilot case-control study presented a novel methodological approach to examining whether Facebook activity following cluster and non-cluster suicides differed. We used a scan statistic to identify suicide cluster cases occurring in spatiotemporal clusters and matched each case to 10 non-cluster control suicides. We identified the Facebook accounts of 3/48 cluster cases and 20/480 non-cluster controls and their respective friends-lists and retrieved 48 posthumous posts and replies (text segments) referring to the deceased for the former and 606 for the latter. We examined text segments for "putatively harmful" and "putatively protective" content (e.g., discussion of the suicide method vs. messages discouraging suicidal acts). We also used concept mapping, word-emotion association, and sentiment analysis and gauged user reactions to posts using the reactions-to-posts ratio. We found no "putatively harmful" or "putatively protective" content following any suicides. However, "family" and "son" concepts were more common for cluster cases and "xx", "sorry" and "loss" concepts were more common for non-cluster controls, and there were twice as many surprise- and disgust-associated words for cluster cases. Posts pertaining to non-cluster controls were four times as receptive as those about cluster cases. We hope that the approach we have presented may help to guide future research to explain suicide clusters and social-media contagion.